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Aftabi H, Sagl B, Lloyd JE, Prisman E, Hodgson A, Fels S. To what extent can mastication functionality be restored following mandibular reconstruction surgery? A computer modeling approach. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2024; 250:108174. [PMID: 38640839 DOI: 10.1016/j.cmpb.2024.108174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 03/26/2024] [Accepted: 04/10/2024] [Indexed: 04/21/2024]
Abstract
STATEMENT OF PROBLEM Advanced cases of head and neck cancer involving the mandible often require surgical removal of diseased sections and subsequent replacement with donor bone. During the procedure, the surgeon must make decisions regarding which bones or tissues to resect. This requires balancing tradeoffs related to issues such as surgical access and post-operative function; however, the latter is often difficult to predict, especially given that long-term functionality also depends on the impact of post-operative rehabilitation programs. PURPOSE To assist in surgical decision-making, we present an approach for estimating the effects of reconstruction on key aspects of post-operative mandible function. MATERIAL AND METHODS We develop dynamic biomechanical models of the reconstructed mandible considering different defect types and validate them using literature data. We use these models to estimate the degree of functionality that might be achieved following post-operative rehabilitation. RESULTS We find significant potential for restoring mandibular functionality, even in cases involving large defects. This entails an average trajectory error below 2 mm, bite force comparable to a healthy individual, improved condyle mobility, and a muscle activation change capped at a maximum of 20%. CONCLUSION These results suggest significant potential for adaptability in the masticatory system and improved post-operative rehabilitation, leading to greater restoration of jaw function.
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Affiliation(s)
- Hamidreza Aftabi
- Department of ECE, University of British Columbia, Vancouver, V6T 1Z4, BC, Canada.
| | - Benedikt Sagl
- Center for Clinical Research, University Clinic of Dentistry, Medical University of Vienna, Vienna, 1090, Austria
| | - John E Lloyd
- Department of ECE, University of British Columbia, Vancouver, V6T 1Z4, BC, Canada
| | - Eitan Prisman
- Department of Surgery, University of British Columbia, Gordon and Leslie Diamond Health Care Centre, Vancouver, V5Z 1M9, BC, Canada
| | - Antony Hodgson
- Department of Mechanical Engineering, University of British Columbia, Vancouver, V6T 1Z4, BC, Canada
| | - Sidney Fels
- Department of ECE, University of British Columbia, Vancouver, V6T 1Z4, BC, Canada
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Sujith A, Sharma N, Guruprasad R, Gupta M. Evaluation of quality of life in posttreatment upper aerodigestive tract cancer patients. J Cancer Res Ther 2023; 19:S234-S240. [PMID: 37148000 DOI: 10.4103/jcrt.jcrt_1533_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Background Cancers of the upper aerodigestive tract constitute approximately 4% of all malignancies. Posttreatment cancer patient faces serious adversities that affect the quality of life. Out of the various scales available to measure the quality of life, we chose the quality of life-oral cancer (QOL-OC), which was developed and evaluated by Nie et al. in 2018. Aims and Objectives The aim of our study was to assess the quality of life in posttreatment upper aerodigestive tract cancer patients in a tertiary care center and also to check the reliability and validity of the questionnaire QOL-OC. Methodology We communicated with 89 patients who were pathologically tested positive for upper aero digestive tract cancer from January 2019 to December 2019. Results The most prevalent adversity was found to be altered salivary flow, followed by diet and difficulty while eating. The QOL-OC was found to be a highly valid and reliable questionnaire. Conclusion The study points out regarding the prevalence of various adversities in post treatment cancer patients, a discussion has also been made suggesting the importance of multidisciplinary approach that should be provided in such patients. Finally, the study also concludes regarding the generalizability of the questionnaire QOL-OC.
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Affiliation(s)
- Akshay Sujith
- Department of Oral Medicine and Radiology, H.P. Government Dental College and Hospital, Shimla, Himachal Pradesh, India
| | - Neeta Sharma
- Department of Oral Medicine and Radiology, H.P. Government Dental College and Hospital, Shimla, Himachal Pradesh, India
| | - R Guruprasad
- Department of Oral Medicine and Radiology, H.P. Government Dental College and Hospital, Shimla, Himachal Pradesh, India
| | - Manish Gupta
- Department of Radiotherapy, Regional Cancer Center, Shimla, Himachal Pradesh, India
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Influence of Radiotherapy on Ossification of Vascularized Osseous Reconstruction of the Jaw: A Radiological Retrospective Cohort Study Based on Panoramic Radiographs. J Clin Med 2022; 11:jcm11175041. [PMID: 36078969 PMCID: PMC9456693 DOI: 10.3390/jcm11175041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 08/11/2022] [Accepted: 08/20/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The aim of this study was to evaluate the impact of irradiation and time of irradiation on the ossification of jaws reconstructed with free bone grafts. Methods: In total, 100 reconstructions of the jaw were retrospectively evaluated for ossification between bone segments by two raters based on postoperative panoramic radiographs (immediate postOP, approximately 6, 12 and 24 months follow-up). Three subgroups were divided according to the time of irradiation: preoperative radiation therapy (n = 41), postoperative radiation therapy (n = 26) and patients without any radiation therapy (n = 33) as the control group. Ossification time and influencing factors were documented. Results: The fastest ossification with a median of 304 ± 37 days was observed (p < 0.001) in the nonirradiated control group. No significant difference (p = 0.087) in ossification was found between the pre- (447 ± 136 days) and postoperative (510 ± 112 days) radiation groups. Ossification between two graft segments (336 ± 38 days) showed significantly (p < 0.001) faster ossification than between the original and grafted bone (448 ± 85 days). Moreover, closer initial contact between the segments resulted in faster ossification (p < 0.001). When analyzing cofactors, tobacco consumption was the only negative factor aggravating ossification (p = 0.006). Conclusion: Head and neck radiation corresponded with the impaired and prolonged ossification of jaw reconstructions with free bone grafts. There was no difference in ossification if radiotherapy was performed before or after reconstructive surgery. A close bony contact was particularly important for ossification between the original and grafted bone.
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Oliveira SV, Vellei RS, Heguedusch D, Domaneschi C, Costa C, de Barros Gallo C. Radiographic analysis of the management of tooth extractions in head and neck-irradiated patients: a case series. Imaging Sci Dent 2021; 51:323-328. [PMID: 34621660 PMCID: PMC8479435 DOI: 10.5624/isd.20200333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 11/25/2022] Open
Abstract
Tooth extraction after head and neck radiotherapy exposes patients to an increased risk for osteoradionecrosis of the jaw. This study reports the results of a radiographic analysis of bone neoformation after tooth extraction in a case series of patients who underwent radiation therapy. No patients developed osteoradionecrosis within a follow-up of 1 year. Complete mucosal repair was observed 30 days after surgery, while no sign of bone formation was observed 2 months after the dental extractions. Pixel intensity and fractal dimension image analyses only showed significant bone formation 12 months after the tooth extractions. These surgical procedures must follow a strict protocol that includes antibiotic prophylaxis and therapy and complete wound closure, since bone formation at the alveolar socket occurs at a slower pace in patients who have undergone head and neck radiotherapy.
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Affiliation(s)
- Samanta V Oliveira
- Stomatology Department, Universidade de Sõo Paulo School of Dentistry, Sõo Paulo, Brazil
| | - Renata S Vellei
- Stomatology Department, Universidade de Sõo Paulo School of Dentistry, Sõo Paulo, Brazil
| | - Daniele Heguedusch
- Stomatology Department, Universidade de Sõo Paulo School of Dentistry, Sõo Paulo, Brazil
| | - Carina Domaneschi
- Stomatology Department, Universidade de Sõo Paulo School of Dentistry, Sõo Paulo, Brazil
| | - Claudio Costa
- Stomatology Department, Universidade de Sõo Paulo School of Dentistry, Sõo Paulo, Brazil
| | - Camila de Barros Gallo
- Stomatology Department, Universidade de Sõo Paulo School of Dentistry, Sõo Paulo, Brazil
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Munhoz L, Nishimura DA, Iida CH, Watanabe PCA, Arita ES. Head and neck radiotherapy-induced changes in dentomaxillofacial structures detected on panoramic radiographs: A systematic review. Imaging Sci Dent 2021; 51:223-235. [PMID: 34621649 PMCID: PMC8479433 DOI: 10.5624/isd.20210011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/17/2021] [Accepted: 02/26/2021] [Indexed: 12/03/2022] Open
Abstract
Purpose This study aimed to summarize the impact of neck and head radiation treatment on maxillofacial structures detected on panoramic radiographs. Materials and Methods In this systematic review, the authors searched PubMed Central, Embase, Scopus, Cochrane Central Register of Controlled Trials, Web of Science, and Google Scholar for original research studies up to February 2020 that included the following Medical Subject Headings keywords: words related to “radiotherapy” and synonyms combined with keywords related to “panoramic radiography” and “oral diagnosis” and synonyms. Only original studies in English that investigated the maxillofacial effects of radiotherapy via panoramic radiographs were included. The quality of the selected manuscripts was evaluated by assessing the risk of bias using Cochrane's ROBINS-I tool for non-randomized studies. Results Thirty-three studies were eligible and included in this review. The main objectives pertained to the assessment of the effects of radiation on maxillofacial structures, including bone architecture alterations, periodontal space widening, teeth development abnormalities, osteoradionecrosis, and implant bone loss. The number of participants evaluated ranged from 8 to 176. Conclusion The interaction between ionizing radiation and maxillofacial structures results in hazard to the tissues involved, particularly the bone tissue, periosteum, connective tissue of the mucosa, and endothelium. Hard tissue changes due to radiation therapy can be detected on panoramic radiographs.
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Affiliation(s)
- Luciana Munhoz
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | | | - Christyan Hiroshi Iida
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Plauto Christopher Aranha Watanabe
- Department of Stomatology, Public Oral Health, and Forensic Dentistry, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Preto, Brazil
| | - Emiko Saito Arita
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
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Gonca M, Gunacar DN, Kose TE, Karamehmetoglu I. Evaluation of mandibular morphologic measurements and trabecular structure among subgroups of impacted mandibular third molars. Oral Radiol 2021; 38:63-71. [PMID: 33870446 DOI: 10.1007/s11282-021-00527-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 04/08/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate mandibular morphologic measurements and trabecular structures that may cause mandibular third molar (MM3) impaction according to MM3 subgroups. METHODS A total of 150 MM3 of 2175 panoramic radiographs (PRs) were reviewed. MM3s according to Winter (vertical), Pell & Gregory Class 1 and group: A, B, C on PRs were included in the study group. Fractal dimensions (FD) and mandibular morphologic measurements were evaluated. Statistical analysis for parametric values was performed using one-way analysis of variance (ANOVA). Statistical analysis for non-parametric values was performed using the Kruskal-Wallis H test. RESULTS Statistically, a significant difference was found only in terms of angle of impaction among the groups of MM3 (p < 0.05) [Winter (vertical), and Pell & Gregory Class 1 and group A, B, C]. There was no difference among groups A, B, C in mandibular morphology and trabecular structure, but group C showed different characteristics than the other groups only in terms of impaction angle. CONCLUSION The trabecular structure and morphometric properties except for the angle of impaction do not affect impacted MM3s with adequate retromolar space and vertical angle.
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Affiliation(s)
- Merve Gonca
- Department of Orthodontics, Faculty of Dentistry, Recep Tayyip Erdoğan University, Rize, Turkey.
| | - Dilara Nil Gunacar
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Taha Emre Kose
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Irem Karamehmetoglu
- Department of Orthodontics, Faculty of Dentistry, Recep Tayyip Erdoğan University, Rize, Turkey
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